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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Objectives To evaluate serum levels of anti-nucleosome and anti-C1q in systemic lupus erythematosus (SLE) patients, and their correlation with disease activity and lupus nephritis (LN) flare. Background SLE is a common chronic multiorgan affection autoimmune disease with loss of self-tolerance and unpredictable activity. Increased serum anti-nucleosome and anti-C1q levels may play pathogenic roles in SLE activity and LN immune aberration and disease flare. Patients and methods The study was carried out on 120 participants, 80 SLE patients and 40 non-SLE individuals as a control group. Of these, 55 patients were diagnosed as LN patients by kidney biopsy before enrollment into the study. Anti-nucleosome antibodies and anti-C1q were determined using a quantitative enzyme-linked immunosorbent assay. Results Anti-nucleosome and anti-C1q serum levels were statistically significantly high in SLE patients in comparison to the control group and statistically significantly high in active SLE patients (111.43 ± 43.97 and 68.62 ± 22.99 U/ml, respectively) than inactive SLE patients. They have significant positive correlations with the SLE disease activity index score (P < 0.001) and have a high sensitivity and specificity for SLE diagnosis and its activity (P < 0.001). Anti-nucleosome and anti-C1q serum levels were statistically significantly high in LN (113.89 ± 43.87 and 68.61 ± 24.49 U/ml, respectively) than in non-LN patients (P = 0.004, P < 0.001, respectively) with statistically significant positive correlations with SLE disease activity index-renal domain score (P < 0.001). They have high sensitivity and specificity for the diagnosis of active LN (P = 0.004, P < 0.001, respectively). Conclusions Anti-nucleosome and anti-C1q can be used as markers for the diagnosis of SLE disease activity and LN flare with high sensitivity and specificity.

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